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We are in a time of great transformation and uncertainty in health care. Fortunately, perioperative physicians are well-positioned to adapt by transitioning to a system that improves efficiency, reduces cost and improves patient care. A central tenet of this solution is ASA’s Perioperative Surgical Home (PSH) model; a concept that lays the groundwork for a more personalized approach to perioperative medicine. The current technological and regulatory environments have created a situation conducive to the development of this concept. ASA’s PSH model is a perioperative redesign that facilitates the personalization of anesthetic and surgical care. Importantly, this framework requires physician leadership in obtaining and tracking results, creating great opportunity for anesthesiologists to evolve in our roles as intraoperative innovators and pioneers in quality assurance.